Prolonged Internal Displacement and Common Mental Disorders in Sri Lanka: The COMRAID Study

Abstract

BackgroundEvidence is lacking on the mental health issues of internally displaced persons, particularly where displacement is prolonged. The COMRAID study was carried out in year 2011 as a comprehensive evaluation of Muslims in North-Western Sri Lanka who had been displaced since 1990 due to conflict, to investigate the prevalence and correlates of common mental disorders.MethodsA cross-sectional survey was carried out among a randomly selected sample of internally displaced people who had migrated within last 20 years or were born in displacement. The total sample consisted of 450 adults aged 18–65 years selected from 141 settlements. Common mental disorders (CMDs) and post-traumatic stress disorder (PTSD) prevalences were measured using the Patient Health Questionnaire and CIDI sub-scale respectively.ResultsThe prevalence of any CMD was 18.8%, and prevalence for subtypes was as follows: somatoform disorder 14.0%, anxiety disorder 1.3%, major depression 5.1%, other depressive syndromes 7.3%. PTSD prevalence was 2.4%. The following factors were significantly associated with CMDs: unemployment (odds ratio 2.8, 95% confidence interval 1.6–4.9), widowed or divorced status (4.9, 2.3–10.1) and food insecurity (1.7, 1.0–2.9).ConclusionsThis is the first study investigating the mental health impact of prolonged forced displacement in post-conflict Sri Lanka. Findings add new insight in to mental health issues faced by internally displaced persons in Sri Lanka and globally, highlighting the need to explore broader mental health issues of vulnerable populations affected by forced displacement.

Internally Displaced “Victims of Armed Conflict” in Colombia: The Trajectory and Trauma Signature of Forced Migration

“…Other nations where internal displacement has occurred within the context of enduring armed conflicts include Uganda [6, 62, 66], Ethiopia [57], Sudan [58, 59, 70, 72, 73, 79, 81], and Sri Lanka [71, 74]. Prior to displacement, future IDPs witness nearby armed conflict and other acts of violence [6, 67•, 68••, 69–77, 71, 74–78]. Additional pre-expulsion stressors include famine, poverty, and religious persecution and strife [57, 74, 83].…”

Post-conflict struggles as networks of problems: A network analysis of trauma, daily stressors and psychological distress among Sri Lankan war survivors

“…COR theory predicts that losses (and trauma, which often represents loss) often interact in loss spirals, i.e., cascading stressors that result in considerable psychological distress (Hobfoll, 2001). COR theory has substantial support in war-affected populations, including Sri Lanka (e.g., Mattock, 2005; Siriwardhana et al, 2013, Somasundaram & Sivayokan, 2013; Witting, Lambert, Wickrama, Thanigaseelan, & Merten, 2016). Other similar theories with empirical support include the daily stressors model, in which the effects of war-related trauma on psychological distress are mediated and moderated by frequent stressors and stressful conditions (Miller & Rasmussen, 2010; 2014; 2017).…”

Impact of Economic Labour Migration: A Qualitative Exploration of Left-Behind Family Member Perspectives in Sri Lanka

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